This study aimed to assess recurrence patterns and related risk factors following curative resection of colorectal cancer (CRC). This retrospective observational study was conducted at a tertiary care center, including 2622 patients with stage I–III CRC who underwent curative resection between 2008 and 2018. Hazard rates of recurrence were calculated using a hazard function. The primary outcome was the peak recurrence time after curative resection and secondary outcomes were prognostic factors associated with recurrence. Over a median follow-up period of 53 months, the overall, locoregional and systemic recurrence rates were 8.9%, 0.7%, and 8.5%, respectively. Recurrence rates were significantly higher for rectal cancer (14.9% overall, 4.4% locoregionally, and 12.3% systemically) than for colon cancer (allp< 0.001). The peak recurrence time was 11 months, with variations in hazard rates and curves depending on the tumor location, stage, and risk factors. Patients with AL or CRM involvement exhibited a distinct pattern, with a high hazard rate in the early postoperative period. Understanding these recurrence patterns and risk factors is crucial for establishing effective postoperative surveillance strategies. Our findings suggested that short-interval surveillance should be considered during the first 2 years post-surgery, particularly for high-risk patients who should receive early attention.
本研究旨在评估结直肠癌根治性切除术后的复发模式及相关风险因素。这项回顾性观察研究在一家三级医疗中心开展，纳入了2008年至2018年间接受根治性切除术的2622例I–III期结直肠癌患者。采用风险函数计算复发风险率。主要研究终点为根治性切除术后的复发高峰时间，次要终点为与复发相关的预后因素。在中位随访53个月期间，总体复发率、局部区域复发率和全身复发率分别为8.9%、0.7%和8.5%。直肠癌的复发率显著高于结肠癌（总体复发率14.9% vs 结肠癌，局部区域复发率4.4%，全身复发率12.3%，所有p值均<0.001）。复发高峰时间为术后11个月，其风险率和风险曲线因肿瘤部位、分期及风险因素而异。伴有吻合口漏或环周切缘阳性的患者呈现独特的复发模式，表现为术后早期高风险率。理解这些复发模式和风险因素对建立有效的术后监测策略至关重要。我们的研究结果表明，术后前2年应考虑进行短间隔监测，尤其对高风险患者需给予早期关注。
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